Endocrinology, Diabetes & Metabolism (Mar 2023)

Two‐year trends from the LANDMARC study: A 3‐year, pan‐India, prospective, longitudinal study on the management and real‐world outcome in patients with type 2 diabetes mellitus

  • Ashok K. Das,
  • Sanjay Kalra,
  • Shashank Joshi,
  • Ambrish Mithal,
  • Prasanna Kumar K. M.,
  • Ambika G. Unnikrishnan,
  • Hemant Thacker,
  • Bipin Sethi,
  • Subhankar Chowdhury,
  • Amarnath Sugumaran,
  • Senthilnathan Mohanasundaram,
  • Shalini K. Menon,
  • Vaibhav Salvi,
  • Deepa Chodankar,
  • Saket Thaker,
  • Chirag Trivedi,
  • Subhash K. Wangnoo,
  • Abdul H. Zargar,
  • Nadeem Rais

DOI
https://doi.org/10.1002/edm2.404
Journal volume & issue
Vol. 6, no. 2
pp. n/a – n/a

Abstract

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Abstract Introduction There are limited data on the real‐world management of diabetes in the Indian population. In this 2‐year analysis of the LANDMARC study, the management of type 2 diabetes mellitus (T2DM) and related complications were assessed. Method This multicenter, observational, prospective study included adults aged ≥25 to ≤60 years diagnosed with T2DM (duration ≥2 years at enrollment) and controlled/uncontrolled on ≥2 anti‐diabetic agents. This interim analysis at 2 years reports the status of glycaemic control, diabetic complications, cardiovascular (CV) risks and therapy, pan‐India including metropolitan and non‐metropolitan cities. Results Of the 6234 evaluable patients, 5318 patients completed 2 years in the study. Microvascular complications were observed in 17.6% of patients (1096/6234); macrovascular complications were observed in 3.1% of patients (195/6234). Higher number of microvascular complications were noted in patients from non‐metropolitan than in metropolitan cities (p < .0001). In 2 years, an improvement of 0.6% from baseline (8.1%) in mean glycated haemoglobin (HbA1c) was noted; 20.8% of patients met optimum glycaemic control (HbA1c < 7%). Hypertension (2679/3438, 77.9%) and dyslipidaemia (1776/3438, 51.7%) were the predominant CV risk factors in 2 years. The number of patients taking oral anti‐diabetic drugs in combination with insulin increased in 2 years (baseline: 1498/6234 [24.0%] vs. 2 years: 1917/5763 [33.3%]). While biguanides and sulfonylureas were the most commonly prescribed, there was an evident increase in the use of dipeptidyl peptidase‐IV inhibitors (baseline: 3049/6234, 48.9% vs. 2 years: 3526/5763, 61.2%). Conclusion This longitudinal study represents the control of T2DM, its management and development of complications in Indian population. Clinical Trial Registration Number CTRI/2017/05/008452.

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